Systems and methods that provide an electrical waveform for neural stimulation or nerve block

ABSTRACT

One aspect of the present disclosure relates to a system that can provide an electric waveform for neural stimulation or nerve block. The system can include a first circuit component configured to provide a self-oscillating, voltage-boosted electric waveform. In some instances, the first circuit component can provide a “pause” waveform (e.g., with a period (T) that includes a swing time (ts) in which the waveform varies in a biphasic manner and a pause time (tp) in which the waveform has a constant amplitude). The system can also include a second circuit component configured to ensure that the oscillating signal is charge-balanced across at least one period of the self-oscillating, voltage-boosted electric waveform.

RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Application No.61/821,873, filed May 10, 2013, entitled “LC-BLOCKING-AND-DC-BALANCINGCIRCUIT.” This application also claims the benefit of U.S. ProvisionalApplication No. 61/824,525, filed May 17, 2013, entitled “BALANCEDELECTRODE SYSTEM.” These provisional applications are herebyincorporated by reference in their entireties for all purposes.

TECHNICAL FIELD

The present disclosure relates generally to neural stimulation and nerveblock and, more specifically, to systems and methods that can provide anelectrical waveform that can be used for neural stimulation or nerveblock.

BACKGROUND

High frequency alternating current waveforms in the kilohertz range(KHFAC waveforms) can provide nerve block (e.g., to control pain and/orspasticity). For example, the nerve block can be immediate, partial,selective, complete, and/or fully reversible. However, many stimulatorsthat can provide KHFAC waveforms are impractical or impossible toincorporate in an implantable neural prosthesis devices. Thesestimulators require a large, heavy battery that is impractical for animplantable device. Additionally, if any portion of the stimulator wereto experience an electric failure, such as open circuit or a shortcircuit, the stimulator could provide a continuous supply of directcurrents (DC) to the stimulation electrode of the neural prosthesis,potentially damaging the electrode and/or the nerve.

SUMMARY

The present disclosure relates generally to neural stimulation and nerveblock and, more specifically, to systems and methods that can provide anelectrical waveform that can be used for neural stimulation or nerveblock. For example, the systems and methods described herein can beeasily incorporated into an implantable neural prosthesis devices forneural stimulation or nerve block.

In one aspect, the present disclosure can include a system that providesan electric waveform for neural stimulation or nerve block. The systemcan include a first circuit component that can be configured to providea self-oscillating, voltage-boosted electric waveform. The system canalso include a second circuit component configured to ensure that theself-oscillating, voltage-boosted electric signal is charge-balancedacross a period of the oscillating electric waveform.

In another aspect, the present disclosure can include a method forproviding a waveform for neural stimulation or nerve block. The methodcan include the step of generating a biphasic waveform characterized byan amplitude that varies biphasicly and configured for neuralstimulation or nerve block. For example, the biphasic waveform can beprovided by a waveform generator device. The method can also include thestep of interrupting the biphasic waveform for a pause time, wherein theinterrupted waveform comprises a substantially constant amplitude. Forexample, the interrupting can be accomplished by a switch coupled to thewaveform generator device.

In a further aspect, the present disclosure can include a waveformgeneration device configured to provide an electric waveform for neuralstimulation or nerve block. The waveform generation device can include afirst circuit component that can be configured to provide aself-oscillating, voltage-boosted electric waveform. The waveformgeneration device can also include a second circuit component can beconfigured to output the self-oscillating, voltage-boosted electricwaveform that is charge-balanced across at least one period of theoscillating electric waveform. The waveform generation device can alsoinclude a switch coupled to the first circuit component or the secondcircuit component. The switch can be configured to short-circuit anoutput of the self-oscillating, voltage-boosted electric waveform duringa pause time interval (e.g., to discharge contaminating noise).

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other features of the present disclosure will becomeapparent to those skilled in the art to which the present disclosurerelates upon reading the following description with reference to theaccompanying drawings, in which:

FIG. 1 is a schematic block diagram showing a system that can provide anelectric waveform for neural stimulation or nerve block, in accordancewith an aspect of the present disclosure;

FIG. 2 is a schematic block diagram showing an example of an oscillatingcircuit component that can be used in the system shown in FIG. 1;

FIG. 3 is a diagram of an example circuit configuration of the systemshown in FIG. 1;

FIG. 4 shows example waveforms that can be produced by the circuit shownin FIG. 3;

FIGS. 5 and 6 are schematic block diagrams showing example placements ofa trigger switch into the system shown in FIG. 1;

FIG. 7-9 are a schematic illustrations of waveforms that can be producedby the systems shown in FIGS. 5 and 6;

FIG. 10 is a process flow diagram illustrating a method for providing anelectric waveform for neural stimulation or nerve block in accordancewith another aspect of the present disclosure; and

FIG. 11 is a process flow diagram illustrating a method for interruptingthe electric waveform provided according to the method shown in FIG. 10.

DETAILED DESCRIPTION I. Definitions

In the context of the present disclosure, the singular forms “a,” “an”and “the” can also include the plural forms, unless the context clearlyindicates otherwise. The terms “comprises” and/or “comprising,” as usedherein, can specify the presence of stated features, steps, operations,elements, and/or components, but do not preclude the presence oraddition of one or more other features, steps, operations, elements,components, and/or groups. As used herein, the term “and/or” can includeany and all combinations of one or more of the associated listed items.Additionally, although the terms “first,” “second,” etc. may be usedherein to describe various elements, these elements should not belimited by these terms. These terms are only used to distinguish oneelement from another. Thus, a “first” element discussed below could alsobe termed a “second” element without departing from the teachings of thepresent disclosure. The sequence of operations (or acts/steps) is notlimited to the order presented in the claims or figures unlessspecifically indicated otherwise.

As used herein, the term “neural prosthesis” or “neural prosthetic” canrefer to one or more devices that can substitute for a neurologicalfunction (e.g., motor function, sensory function, cognitive function,etc.) that has been damaged (e.g., as a result of a neurologicaldisorder). For example, a neural prosthesis can include a stimulationdevice that restores neurological function (“neural stimulation”) and/ora blocking device that blocks nerve conduction (“nerve block”). The term“stimulation waveform,” as used herein, can encompass an electricalwaveform used for neural stimulation and an electrical waveform used fornerve block.

As used herein, the term “nerve” can refer to a “peripheral nerve.”Generally, a peripheral nerve can refer to a nerve in a patient's bodyother than brain and spinal cord. A peripheral nerve can include abundle of fibers (including motor and sensory fibers) that can connectthe brain and spinal cord to the rest of the patient's body. Forexample, a peripheral nerve can control the functions of sensation,movement, and motor coordination. In some instances, the peripheralnerve can conduct information bi-directionally (e.g., providing bothmotor control and sensory feedback).

As used herein, the term “electric waveform” can refer to an electricalsignal that can be generated by a waveform generator and applied to thenerve with an electrode to achieve neural stimulation or nerve block. Insome instances, the electrical waveform can be a mathematicaldescription of a change in voltage over time (or “voltage controlled”)or a change in current over time (or “current controlled”). In someinstances, the electric waveform can be a biphasic waveform. The terms“electric waveform,” “stimulation waveform,” “waveform,” and “signal”can be used interchangeably herein.

As used herein, the term “biphasic waveform” can refer to an electricwaveform that includes both an anodic phase of the waveform and acathodic phase. The anodic phase and the cathodic phase can be appliedin either order. Examples of biphasic waveforms can include a pulsedwaveform, a sinusoidal waveform, a near sinusoidal waveform, a highfrequency electric alternating current (KHFAC) waveform (e.g., in thekilohertz frequency range), a charge-balanced direct current (CBDC)waveform, or a multi-phased direct current (MPDC) waveform.

As used herein, the term “substantially constant” can refer to acomplete (e.g., 100%) or partial (e.g., less than 100%, such as about90%, about 80%, about 70%, about 60%, or less than about 50%) constantamplitude electric waveform. Unless indicated otherwise, the terms“substantially constant” and “constant” can be used interchangeablyherein.

As used herein, the term “medical professional” can refer to can referto any person involved in medical care of a patient including, but notlimited to, physicians, medical students, nurse practitioners, nurses,and technicians.

As used herein, the term “patient” can refer to any warm-bloodedorganism including, but not limited to, a human being, a pig, a rat, amouse, a dog, a cat, a goat, a sheep, a horse, a monkey, an ape, arabbit, a cow, etc. The terms “patient” and “subject” can be usedinterchangeably herein.

II. Overview.

The present disclosure relates generally to neural stimulation and nerveblock and, more specifically, to systems and methods that can provide anelectrical waveform that can be used for neural stimulation or nerveblock. For example, the systems and methods described herein can beeasily incorporated into an implantable neural prosthesis devices forneural stimulation or nerve block. For example, a system as describedherein can operate on a very low supply voltage (e.g., 0 Volts-9 Volts),allowing the circuit to run longer on smaller implanted batteries.

In some instances, a system can provide an electric waveform for neuralstimulation or nerve block. The system can include a first circuitcomponent configured to provide a self-oscillating, voltage-boostedelectric waveform. The system can also include a second circuitcomponent configured to ensure that the oscillating signal ischarge-balanced across a period of the self-oscillating, voltage-boostedelectric waveform.

III. Systems

One aspect of the present disclosure can include a system that can thatcan provide an electric waveform for neural stimulation or nerve block.In some instances, the electric waveform can be a charge-balanced,biphasic waveform. For example, the charge-balanced, biphasic waveformcan be self-oscillating and voltage-boosted.

As shown in FIG. 1, one aspect of the present disclosure can include asystem 10 configured to provide an electric waveform for neuralstimulation or nerve block. For example, the electrical waveform can bea charge-balanced, self-oscillating, voltage-boosted electric waveform.The voltage boosting capabilities of system 10 can allow system 10 to beincorporated into a waveform generator that can be part of animplantable neural stimulator. The implantable neural stimulator can beused within a neural prosthesis device. The system 10 can be powered bya small battery within the implantable device, and the battery canexhibit an extended life between battery changes. In some instances,system 10 can receive power temporarily by a capacitance substitutingfor a battery.

The system 10 can include components including at least an oscillatingcircuit component 12 and a balancing circuit component 14. Theoscillating circuit component 12 can be configured to provide aself-oscillating, voltage-boosted electric waveform (EW) to thebalancing circuit component 14. For example, the oscillating circuit canbe configured to utilize Lenz's law to facilitate an amplification of asupply voltage from a battery to provide the self-oscillating,voltage-boosted electric waveform (EW).

In some instances (e.g., as shown in FIG. 2), the oscillating circuitcomponent can include a voltage amplifying component 22 and a resonatingcomponent 24. The voltage amplifying component 22 can be is configuredto generate voltage pulses that are amplified from a supply voltage froma battery. In some instances, the voltage-amplifying circuit can includeone or more of: a diode, a relay, a transistor, and an inductor (e.g.,provided by a toroid, a transformer, or a multi-coil inductor). Forexample, the voltage-amplifying component 22 can include a circuit basedon a joule thief circuit, a joule ringer circuit, and/or a fly-backtransformer circuit.

The resonating component 24 can be configured to generate aself-oscillating signal. In some instances, the resonating component 24can include at least one inductor (e.g., provided by a toroid, atransformer, or a multi-coil inductor) and at least one capacitor toform an LC resonating circuit. The LC resonating circuit can includeother circuit elements (e.g., one or more resistors).

Referring again to FIG. 1, the balancing circuit component 14 can beconfigured to ensure that the self-oscillating, voltage boosted electricwaveform is charged balanced. In some instances, the balancing circuitcomponent 14 can be configured to remove contaminating noise from theself-oscillating, voltage-boosted electric waveform (EW) to facilitatethe charge balancing.

The system 10 can output the charge-balanced, self-oscillating,voltage-boosted electric waveform (CBEW). In some instances, the outputcan be current controlled. In other instances, the output can be voltagecontrolled.

One example implementation of the system 10 is shown in the circuitdiagram 30 of FIG. 3. For example, the oscillating circuit component 12of system 10 can include elements a (e.g., voltage amplifying component22 of FIG. 2) and b (e.g., resonating component 24 of FIG. 2) of thecircuit diagram 30 and the balancing circuit component 14 can includeelement c of the circuit diagram 30. As depicted in circuit diagram 30,element a can be based on a joule-thief circuit, a joule-ringer circuitor a fly-back transformer circuit, element b can be a resonatingRC-circuit (e.g., that can “round” the waveform), and element c can be atransformer that can balance the charge in the output waveform.

Examples of different outputs that can be output from circuitillustrated in circuit diagram 30 are shown in FIG. 4. Each plot 40, 42,44, and 46 is biphasic and charge-balanced. Moreover, each plot 40, 42,44, and 46 is self-oscillating and voltage-boosted. The different plots40, 42, 44, and 46 are generated by altering the circuit components indifferent ways.

The circuit components of the circuit in circuit diagram 30 can bealtered to change the form (e.g., parameters) of the output. In someinstances, the output can be fixed in waveform shape, pulse-width,cathodic and anodic amplitudes, and frequency. For example, the waveformshape can be varied by one or more of: the choice of resistors, thechoice of diode (D1), the choice of inductor/toroid/number of windings,and the capacitor (C1) in direct connection to the toroid. As anotherexample, the fundamental frequency can be varied by one of more of:choice of diode (D1), choice of capacitor (C1) and resistor (R1), choiceof resistors (R2, R3, and/or R4), and choice of inductor/toroid/numberof windings. In a further example, the pulse width can be varied by oneor more of: choice of capacitor (C1) and resistor (R1), choice ofresistors (R2, R3, and/or R4), and choice of inductor/toroid/number ofwindings. In yet another example, the on-time/off-time of the output canbe varied by one or more of: choice of the diode (D1) and choice ofresistor (R3).

As shown in FIGS. 5 and 6, systems 50 and 60 (respectively) can includea trigger switch 32 that can be configured to interrupt transmission ofthe electric waveform (EW). The trigger switch 32 can be located withinthe oscillating circuit component 12, between the oscillating circuitcomponent and the balancing circuit component 14, within the balancingcircuit component, or at the output of the system 10. When the triggerswitch 32 is in an open configuration, an open circuit can be createdthrough at least one path of the oscillating circuit component 12 or thebalancing circuit component 14.

In some instances, the trigger switch 32 can be operated by theoscillating circuit component 12 to short circuit transmission of theelectric waveform in at least one of the oscillating circuit component12 or the balancing circuit component 14 to provide a zero-amplitudewaveform as an output of the system 50 at one or more time points(“pause time”). An example of a waveform 70 with a biphasic portion andan interrupted portion is shown in FIG. 7. The biphasic portion can havea cathodic phase and an anodic phase (in either order). As illustrated,the cathodic phase occurs over a first time period (tsc), and the anodicphase occurs over a second time period (tsa). The sum of the first timeperiod and the second time period can be defined as the swing time (ts)of the biphasic waveform (or ts=tsc+tsa). The interrupted portion canoccur over a pause time (tp) where the waveform can have a substantiallyconstant amplitude. The period of the entire waveform 70 (T) can bedefined as the sum of the swing time and the pause time (T=ts+tp). Thebiphasic waveform can be charge-balanced during the time period (T).

In some instances, the pause waveform can be provided by a waveformgenerator. For example, the waveform generator can include a triggerswitch that can create an open circuit with the waveform generator(e.g., shorting one or both lines of a channel of the waveformgenerator) to discharge contaminating noise (e.g., a direct current (DC)component). In another example, the trigger switch can create an opencircuit within the waveform generator to interrupt the biphasic waveformfor the pulse time. In another example, the waveform generator can bethe system 50 or 60 where the trigger switch 32 can be configured tointerrupt the output of the self-oscillating, voltage-boosted electricwaveform for the pause time interval upon completion of at least onecathodic phase and/or at least one anodic phase.

During the pause time, the waveform can have a substantially constantamplitude. For example, the substantially constant amplitude can beprovided to one or more output terminals of the waveform generatorduring the pause time. Different examples of waveforms with pause timesare shown in FIGS. 8 and 9.

In FIG. 8 elements 80 and 82 show a substantially constant amplitude ofzero Amps during the pause time (the amplitude could alternatively bezero Volts). Element 80 illustrates the same polarity biphasic waveformbefore and after the pause time. Element 82 illustrates differentpolarities of the biphasic waveform (e.g., a reversed polarity) beforeand after the pause time. In some instances, reversing the polarity ofthe waveform can provide charge balancing of the overall waveform overtwo or more periods (T).

In FIG. 9, element 84 shows a substantially constant amplitude that isnon-zero Amps (the amplitude could alternatively be a non-zero value inVolts). In some instances, during the non-zero amplitude pause time, thewaveform generator can send and/or receive data with a reduction innoise.

It will be understood that the “waveform generator” or “waveformgeneration device” as used herein can be any device that can generate abiphasic waveform. In some instances, the waveform generator or waveformgeneration device can include one or more components of system 10,system 20, system 50 or system 60.

IV. Methods

Another aspect of the present disclosure can include methods that canprovide a waveform for neural stimulation or nerve block, according toan aspect of the present disclosure. An example of a method 1000 thatcan provide an electric waveform (e.g., as shown in FIG. 4) for neuralstimulation or nerve block is shown in FIG. 10. Another example of amethod 1100 that can interrupt an electrical waveform (e.g., as providedby method 1000) to form a pause waveform (e.g., as show in FIGS. 7-9) isshown in FIG. 11.

The methods 1000 and 1100 of FIGS. 10 and 11, respectively, areillustrated as process flow diagrams with flowchart illustrations. Forpurposes of simplicity, the methods 1000 and 1100 are shown anddescribed as being executed serially; however, it is to be understoodand appreciated that the present disclosure is not limited by theillustrated order as some steps could occur in different orders and/orconcurrently with other steps shown and described herein. Moreover, notall illustrated aspects may be required to implement the methods 1000and 1100.

Referring to FIG. 10, an aspect of the present disclosure can include amethod 1000 for providing an electrical waveform (e.g., as shown in FIG.4) for neural stimulation or nerve block. In some instances, the method1000 can be accomplished by a waveform generation device. For example,the waveform generation device can be an implantable neural stimulatorthat can be used in connection with a neural prosthetic device.

At 1002, a self-oscillating, voltage-boosted electric waveform (e.g.,EW) can be provided (e.g., by oscillating circuit component 12). Forexample, the self-oscillating, voltage-boosted electric waveform can begenerated according to Lenz's law to facilitate an amplification of asupply voltage from a battery.

At 1004, the charge during a period of the self-oscillating,voltage-boosted waveform can be balanced (e.g., by balancing circuitcomponent 14). The charge-balanced, self-oscillating, voltage-boostedwaveform can be an output of a system implementing the method. In someinstances, the output can be current-controlled. In other instances, theoutput can be voltage controlled.

In some instances, during the charge-balancing, any contaminating noise(e.g., direct current (DC) components) in the self-oscillating,voltage-boosted electric waveform can be removed. By removing thecontaminating noise, the charge-balanced, self-oscillating,voltage-boosted waveform can be safer for the neural stimulation ornerve block (e.g., the waveform will be less likely to damage the nerve,the electrode applying the waveform, and/or the waveform generator).

Referring now to FIG. 11, another aspect of the present disclosure caninclude a method 1100 for interrupting an electrical waveform (e.g., asprovided by method 1000) to form a pause waveform (e.g., as show inFIGS. 7-9).

At 1102, a biphasic waveform (e.g., as shown in FIG. 4) configured forneural stimulation or nerve block can be generated. In some instances,the biphasic waveform can be generated by a waveform generation device(e.g., at least a portion of the systems 10 or 20 as shown in FIG. 1 or2). For example, the biphasic waveform can be an electrical waveformthat can be generated by steps 1002 (in which a self-oscillating,voltage-boosted electric waveform (e.g., EW) can be provided (e.g., byoscillating circuit component 12)) and 1004 (in which the charge duringa period of the self-oscillating, voltage-boosted waveform can bebalanced (e.g., by balancing circuit component 14)) of FIG. 10.

At 1104, the biphasic waveform can be interrupted (e.g., by a triggerswitch 32 creating an open circuit within the waveform generator toshort out the output internally and by shorting one or more lines of achannel of the waveform generator) during the pause time to dischargecontaminating noise (e.g., example waveforms with pause times (“pausewaveforms”) are shown in FIGS. 7-9). The interrupted waveform can have asubstantially constant amplitude. In some instances, the amplitude canbe about zero Volts or zero Amps. In other instances, the amplitude canbe a non-zero value of voltage or current.

For example, the biphasic waveform and the interrupted waveform togethercan have a period (T) that is equal to the sum of a swing time (ts) anda pause time (tp). In some instances the swing time (ts) can include thetime to complete both phases of the biphasic waveform. In otherinstances, the swing time (ts) can include a time to complete a singlephase of the biphasic waveform. The pause time can stop the biphasicwaveform at a high level (e.g., the maximum amplitude of the biphasicwaveform), at an intermediate level (e.g., between zero and the maximumamplitude of the biphasic waveform), or at an amplitude of zero.

In some instances, the biphasic waveform can be charge-balanced duringthe time period (T). For example, unbalanced charge (e.g., due tocontaminating DC noise) can be discharged during the pause time.

From the above description, those skilled in the art will perceiveimprovements, changes and modifications. Such improvements, changes andmodifications are within the skill of one in the art and are intended tobe covered by the appended claims.

What is claimed is:
 1. A system that provides an electric waveform forneural stimulation or nerve block, the system comprising: a firstcircuit component configured to provide a self-oscillating,voltage-boosted electric waveform; and a second circuit componentconfigured to ensure that the self-oscillating, voltage-boosted electricwaveform is charge-balanced across at least one period of the aself-oscillating, voltage-boosted electric waveform.
 2. The system ofclaim 1, wherein the first circuit component is configured to utilizeLenz's law to facilitate an amplification of a supply voltage from abattery to provide the self-oscillating, voltage-boosted electricwaveform.
 3. The system of claim 1, wherein an output of the systemcomprises the charge-balanced self-oscillating, voltage-boostedwaveform.
 4. The system of claim 3, wherein the second circuit componentis configured to ensure that the output of the system is free ofcontaminating direct current (DC) components.
 5. The system of claim 1,wherein the output of the system is current controlled.
 6. The system ofclaim 1, wherein the output of the system is voltage controlled.
 7. Thesystem of claim 1, wherein the first circuit component comprises aresonating circuit comprising at least one inductor and at least onecapacitor.
 8. The system of claim 7, wherein the first circuit componentfurther comprises at least one resistor.
 9. The system of claim 7,wherein the at least one inductor is provided by a toroid, atransformer, or a multi-coil inductor.
 10. The system of claim 7,wherein the first circuit component further comprises at least one of atransistor, a diode, and a relay.
 11. The system of claim 1, furthercomprising a trigger switch configured to interrupt transmission of theelectric waveform through at least one path of the first circuitcomponent or the second circuit component.
 12. The system of claim 11,wherein the trigger switch is at least one of: located between the firstcircuit component and the second circuit component; and located withinthe second circuit component.
 13. The system of claim 11, wherein thetrigger switch is operated by the first circuit component and configuredto short-circuit the electric waveform in at least one of the firstcircuit component and the second circuit component to provide azero-amplitude waveform as an output of the system at a plurality oftime points.
 14. A method for providing a waveform for neuralstimulation or nerve block, the method comprising the steps of:generating, by a waveform generator device, a biphasic waveformcharacterized by an amplitude that varies in a biphasic manner andconfigured for neural stimulation or nerve block; and interrupting, by aswitch coupled to the waveform generator device, the biphasic waveformfor a pause time, wherein the interrupted waveform comprises asubstantially constant amplitude.
 15. The method of claim 14, whereinthe substantially constant amplitude is zero Volts or zero Amps.
 16. Themethod of claim 14, wherein the step of generating the biphasic waveformfurther comprises utilizing Lenz's law to facilitate an amplification ofa supply voltage from a battery to provide the biphasic waveform,wherein the biphasic waveform is self-oscillating and voltage-boosted.17. The method of claim 14, wherein a time period (T) comprises a swingtime (t_(s)) to complete both phases of the biphasic waveform and thepause time (t_(p)), so that T=t_(s)+t_(p).
 18. The method of claim 14,wherein the biphasic waveform is charge-balanced during at least onetime period (T).
 19. The method of claim 14, wherein the switch coupledto the waveform generator interrupts the biphasic waveform by shortingboth lines of a channel of the waveform generator, and furthercomprising the step of discharging a direct current (DC) component ofthe waveform during the pause time.
 20. The method of claim 14, whereinthe step of interrupting the biphasic waveform further comprisescreating an open circuit within the waveform generator to interrupt thebiphasic waveform for the pause time.
 21. A waveform generation deviceconfigured to provide an electric waveform for neural stimulation ornerve block, comprising: a first circuit component configured to providea self-oscillating, voltage-boosted electric waveform; a second circuitcomponent configured to output the self-oscillating, voltage-boostedelectric waveform that is charge-balanced across a period of theoscillating electric waveform; and a switch coupled to the first circuitcomponent or the second circuit component, wherein the switch isconfigured to short-circuit an output of the self-oscillating,voltage-boosted electric waveform for a pause time interval.
 22. Thewaveform generation device of claim 21, wherein the switch is configuredto interrupt the output of the self-oscillating, voltage-boostedelectric waveform for the pause time interval upon completion of atleast one cathodic phase or at least one anodic phase.
 23. The waveformgeneration device of claim 21, wherein the interrupted waveformcomprises a substantially constant voltage or current amplitude providedto the output terminals of the waveform generation device during thepause time interval.
 24. The waveform generation device of claim 21,wherein during the pause time, a direct current (DC) component of theself-oscillating, voltage-boosted electric waveform discharges toachieve a charge balanced electric waveform for neural stimulation orneural block.
 25. The waveform generation device of claim 21, whereinduring the pause time, the polarity of the waveform is reversed toprovide charge balancing of the overall waveform over two or more timeperiods T.
 26. The waveform generation device of claim 21, whereinduring the pause time, the waveform generation device sends or receivesdata with a temporarily higher signal to noise ration due at least inpart to a reduction in noise caused by the waveform generation device.